Presentation
Weakness
Patient Data
Intradural extramedullary mass at the level of T5/6 lying adjacent to the left postero-lateral margin of the thoracic cord. The lesion demonstrates evidence of enhancement with areas of smooth thin enhancing dura extending both superior and inferior to the lesion likely reactive. Faint increased cord T2 hyperintensity across this segment of the compressed cord is present. No further intraspinal lesion identified across the thoracic spine. No suspicious osseous lesion.
Conclusion: Partially calcified lesion with reactive dural thickening along the left postero-lateral margin of the thoracic cord at T5/6 almost certainly a meningioma.
A calcified lesion within the vertebral canal at the left posterolateral aspect of the T5/T6 level correlates with the known meningioma.
Case Discussion
The patient went on to have a resection.
Histology
Sections show a tumor composed of spindled cells with indistinct cell membranes and oval nuclei with vesicular chromatin and occasional nuclear inclusions. Cells form small nests and whorled collections and in other areas are streaming in association with variably sized collagen bundles. Psammomatous calcification is also present within the tumor. Mitoses are not seen.
FINAL DIAGNOSIS: meningioma (WHO I)